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Li X, Tang K. The Effects of Online Health Information-Seeking Behavior on Sexually Transmitted Disease in China: Infodemiology Study of the Internet Search Queries. J Med Internet Res 2023; 25:e43046. [PMID: 37171864 DOI: 10.2196/43046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 03/11/2023] [Accepted: 03/30/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Sexually transmitted diseases (STDs) are a serious issue worldwide. With the popularity of the internet, online health information-seeking behavior (OHISB) has been widely adopted to improve health and prevent disease. OBJECTIVE This study aimed to investigate the short-term and long-term effects of different types of OHISBs on STDs, including syphilis, gonorrhea, and AIDS due to HIV, based on the Baidu index. METHODS Multisource big data were collected, including case numbers of STDs, search queries based on the Baidu index, provincial total population, male-female ratio, the proportion of the population older than 65 years, gross regional domestic product (GRDP), and health institution number data in 2011-2018 in mainland China. We categorized OHISBs into 4 types: concept, symptoms, treatment, and prevention. Before and after controlling for socioeconomic and medical conditions, we applied multiple linear regression to analyze associations between the Baidu search index (BSI) and Baidu search rate (BSR) and STD case numbers. In addition, we compared the effects of 4 types of OHISBs and performed time lag cross-correlation analyses to investigate the long-term effect of OHISB. RESULTS The distributions of both STD case numbers and OHISBs presented variability. For case number, syphilis, and gonorrhea, cases were mainly distributed in southeastern and northwestern areas of China, while HIV/AIDS cases were mostly distributed in southwestern areas. For the search query, the eastern region had the highest BSI and BSR, while the western region had the lowest ones. For 4 types of OHISB for 3 diseases, the BSI was positively related to the case number, while the BSR was significantly negatively related to the case number (P<.05). Different categories of OHISB have different effects on STD case numbers. Searches for prevention tended to have a larger impact, while searches for treatment tended to have a smaller impact. Besides, due to the time lag effect, those impacts would increase over time. CONCLUSIONS Our study validated the significant associations between 4 types of OHISBs and STD case numbers, and the impact of OHISBs on STDs became stronger over time. It may provide insights into how to use internet big data to better achieve disease surveillance and prevention goals.
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Affiliation(s)
- Xuan Li
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Kun Tang
- Vanke School of Public Health, Tsinghua University, Beijing, China
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2
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Zheng J, Shen G, Hu S, Han X, Zhu S, Liu J, He R, Zhang N, Hsieh CW, Xue H, Zhang B, Shen Y, Mao Y, Zhu B. Small-scale spatiotemporal epidemiology of notifiable infectious diseases in China: a systematic review. BMC Infect Dis 2022; 22:723. [PMID: 36064333 PMCID: PMC9442567 DOI: 10.1186/s12879-022-07669-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/03/2022] [Indexed: 11/20/2022] Open
Abstract
Background The prevalence of infectious diseases remains one of the major challenges faced by the Chinese health sector. Policymakers have a tremendous interest in investigating the spatiotemporal epidemiology of infectious diseases. We aimed to review the small-scale (city level, county level, or below) spatiotemporal epidemiology of notifiable infectious diseases in China through a systematic review, thus summarizing the evidence to facilitate more effective prevention and control of the diseases. Methods We searched four English language databases (PubMed, EMBASE, Cochrane Library, and Web of Science) and three Chinese databases (CNKI, WanFang, and SinoMed), for studies published between January 1, 2004 (the year in which China’s Internet-based disease reporting system was established) and December 31, 2021. Eligible works were small-scale spatial or spatiotemporal studies focusing on at least one notifiable infectious disease, with the entire territory of mainland China as the study area. Two independent reviewers completed the review process based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results A total of 18,195 articles were identified, with 71 eligible for inclusion, focusing on 22 diseases. Thirty-one studies (43.66%) were analyzed using city-level data, 34 (47.89%) were analyzed using county-level data, and six (8.45%) used community or individual data. Approximately four-fifths (80.28%) of the studies visualized incidence using rate maps. Of these, 76.06% employed various spatial clustering methods to explore the spatial variations in the burden, with Moran’s I statistic being the most common. Of the studies, 40.85% explored risk factors, in which the geographically weighted regression model was the most commonly used method. Climate, socioeconomic factors, and population density were the three most considered factors. Conclusions Small-scale spatiotemporal epidemiology has been applied in studies on notifiable infectious diseases in China, involving spatiotemporal distribution and risk factors. Health authorities should improve prevention strategies and clarify the direction of future work in the field of infectious disease research in China. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07669-9.
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Affiliation(s)
- Junyao Zheng
- China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China.,School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
| | - Guoquan Shen
- School of Public Administration and Policy, Renmin University of China, Beijing, China
| | - Siqi Hu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Xinxin Han
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, 518055, Guangdong, China
| | - Siyu Zhu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Jinlin Liu
- School of Public Policy and Administration, Northwestern Polytechnical University, Xi'an, China
| | - Rongxin He
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Ning Zhang
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China.,MRC Centre for Global Infectious Disease Analysis and the Abdul Latif Jameel Institute for Disease and Emergency Analytics, School of Public Health, Imperial College, London, UK
| | - Chih-Wei Hsieh
- Department of Public Policy, City University of Hong Kong, Hong Kong, China
| | - Hao Xue
- Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, USA
| | - Bo Zhang
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Yue Shen
- Laboratory for Urban Future, School of Urban Planning and Design, Peking University Shenzhen Graduate School, Shenzhen, China
| | - Ying Mao
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Bin Zhu
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, 518055, Guangdong, China.
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Gong R, Wang S, Ji Y, Li Z, Chang R, Zhang S, Yu X, Xu C, Cai Y, Ni Y. Social exclusion, thwarted belongingness, and perceived burdensomeness: construct validity and psychometric properties of the Interpersonal Needs Questionnaire among patients with sexually transmitted infections in Shanghai, China. BMC Psychol 2022; 10:29. [PMID: 35164883 PMCID: PMC8842558 DOI: 10.1186/s40359-022-00726-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 01/26/2022] [Indexed: 12/20/2022] Open
Abstract
Abstract
Background
Sexually transmitted infections (STIs) are a serious public health problem worldwide. Patients with STIs have a high rate of psychosocial problems and may perceive unmet interpersonal needs, which is considered a proximal and sufficient cause of suicidal thoughts and behaviors. The present study examined the construct validity and psychometric properties of the 15-item Interpersonal Needs Questionnaire among patients with STIs in Shanghai, China.
Methods
We recruited 910 patients with STIs (438 males and 472 females; mean age = 38.72, standard deviation [SD] = 13.034) from the Shanghai Skin Disease Hospital using accidental sampling. Baseline descriptive statistics were calculated using R 4.0.0, and a latent variable model was developed using Mplus 7.4.
Results
The construct validity results supported a latent variable measurement model with three distinct but related constructs (thwarted belongingness, perceived burdensomeness, and social exclusion) (p < 0.001, χ2/df = 2.475, root mean square error of approximation = 0.057, comparative fit index = 0.931, Tucker–Lewis index = 0.916, standardized root mean residual = 0.044). The Cronbach’s α and McDonald’s ω values were 0.849 and 0.767 for the total scale, 0.888 and 0.889 for perceived burdensomeness, 0.764 and 0.777 for social exclusion, and 0.892 and 0.893 for thwarted belongingness. Interpersonal needs were significantly associated with low self-esteem (r = 0.539), loneliness (r = 0.573), depression (r = 0.338), entrapment (r = 0.420), defeat (r = 0.579), and low perceived social support (r = 0.424).
Conclusions
This was the first study to highlight social exclusion as a distinct but related dimension of interpersonal needs. This finding indicates that patients with STIs perceive high social exclusion. Therefore, health providers should consider the psychological status of these patients and implement strategies to support their integration into society.
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Tang S, Shi L, Chen W, Zhao P, Zheng H, Yang B, Wang C, Ling L. Spatiotemporal distribution and sociodemographic and socioeconomic factors associated with primary and secondary syphilis in Guangdong, China, 2005-2017. PLoS Negl Trop Dis 2021; 15:e0009621. [PMID: 34383788 PMCID: PMC8407558 DOI: 10.1371/journal.pntd.0009621] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 08/31/2021] [Accepted: 07/02/2021] [Indexed: 11/30/2022] Open
Abstract
Background Previous studies exploring the factors associated with the incidence of syphilis have mostly focused on individual-level factors. However, recent evidence has indicated that social-level factors, such as sociodemographic and socioeconomic factors, also affect the incidence of syphilis. Studies on the sociodemographic and socioeconomic factors associated with syphilis incidence are scarce, and they have rarely controlled for spatial effects, even though syphilis shows spatial autocorrelation. Methodology/Principal findings Syphilis data from 21 cities in Guangdong province between 2005 and 2017 were provided by the National Notifiable Infectious Disease Reporting Information System. The incidence time series, incidence map, and space-time scanning data were used to visualize the spatiotemporal distribution. The spatial panel data model was then applied to explore the relationship between sociodemographic factors (population density, net migration rate, male:female ratio, and the number of health institutions per 1,000 residents), socioeconomic factors (gross domestic product per capita, the proportion of secondary/tertiary industry), and the incidence of primary and secondary syphilis after controlling for spatial effects. The incidence of syphilis increased slowly from 2005 (11.91 per 100,000) to 2011 (13.42 per 100,000) and then began to decrease, reaching 6.55 per 100,000 in 2017. High-risk clusters of syphilis tended to shift from developed areas to underdeveloped areas. An inverted U-shaped relationship was found between syphilis incidence and gross domestic product per capita. Moreover, syphilis incidence was significantly associated with population density (β = 2.844, P = 0.006), the number of health institutions per 1,000 residents (β = -0.095, P = 0.007), and the net migration rate (β = -0.219, P = 0.002). Conclusions/Significance Our findings suggest that the incidence of primary and secondary syphilis first increase before decreasing as economic development increases further. These results emphasize the necessity to prevent syphilis in regions at the early stages of economic growth. Syphilis is a sexually transmitted infection that continues to cause morbidity and mortality worldwide. The primary and secondary stages of syphilis are the most transmissive stages in the entire process of the disease. We analyzed primary and secondary (P&S) syphilis data from 2005 to 2017 in Guangzhou, China, provided by the National Notifiable Infectious Disease Reporting Information System. The results showed that the annual incidence rates of P&S syphilis slightly increased from 2005 to 2011 and then began to decrease in 2017. Cases of P&S syphilis were spatially clustered. The high-risk syphilis clusters tended to shift from developed areas to underdeveloped areas. There may be an inverted U-shaped relationship between the level of economic development and the incidence of P&S syphilis, suggesting that the incidence of P&S syphilis first increased before decreasing as the level of economic development increased further. These results emphasize the necessity of preventing syphilis at locations in the early stage of economic growth. Investments in syphilis prevention education for people in regions at early development stages may mitigate the increasing cost of syphilis to future healthcare systems.
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Affiliation(s)
- Shangqing Tang
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Lishuo Shi
- Clinical Research Center, The sixth affiliated hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Wen Chen
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Peizhen Zhao
- Dermatology Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Institute for Global Health and Sexually Transmitted Disease, Southern Medical University, Guangzhou, Guangdong, China
| | - Heping Zheng
- Dermatology Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Institute for Global Health and Sexually Transmitted Disease, Southern Medical University, Guangzhou, Guangdong, China
| | - Bin Yang
- Dermatology Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Institute for Global Health and Sexually Transmitted Disease, Southern Medical University, Guangzhou, Guangdong, China
| | - Cheng Wang
- Dermatology Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Institute for Global Health and Sexually Transmitted Disease, Southern Medical University, Guangzhou, Guangdong, China
- * E-mail: (CW); (LL)
| | - Li Ling
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
- * E-mail: (CW); (LL)
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Smith MK, Searle KM, Yang W, Rapheal E, Wang C, Zhao P, Yang L, Huang S, Yang B. Spatiotemporal analysis of 11 years of Chlamydia trachomatis data from southern China. LANCET REGIONAL HEALTH-WESTERN PACIFIC 2021; 11:100143. [PMID: 34327356 PMCID: PMC8315467 DOI: 10.1016/j.lanwpc.2021.100143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/08/2021] [Accepted: 03/19/2021] [Indexed: 11/19/2022]
Abstract
Background Urogenital Chlamydia trachomatis is the most prevalent bacterial sexually transmitted infection (STI) globally. Reviews suggest high and persistently endemic STI epidemics in low and middle income countries. However population-based prevalence estimates in these settings are less common, underscoring the need for analyses of available data to characterize patterns of disease burden. We identified spatio-temporal clusters and key behavioral, social, or environmental factors contribution to transmission in order to inform the prioritization and targeting of evidence based interventions. Methods Using 11 years of data (2006-2016) from the chlamydia case report system of Guangdong, China, we identified county level spatio-temporal hot and cold spots using the Getis-Ord Gi* statistic and discrete Poisson models in SaTScan 9.6. We also estimated associations between observed distribution patterns and area-level demographic, social, and economic factors using quasi-Poisson regression models that controlled for annual counts of certified laboratories to account for fluctuations in location-specific detection capacity. Findings Cluster analysis indicates an expanding chlamydia epidemic in Guangdong, with cases clustered in regions of greatest economic activity. Greater male-to-female sex ratio (RR, 3.63; 95% CI, 1.41-9.45) and greater urbanicity (RR, 2.44; 95% CI, 1.98-2.99) were predictive of higher chlamydia case occurrence. Interpretation We found that chlamydia case occurrence in Guangdong province has been accelerating over the past 11 years and that its expansion is tied to indicators of social and economic development. These estimates not only identify high prevalence regions to target but also areas where data gaps potentially remain. The salience of sex ratios and urbanicity may best be understood through the lens of China's modern history of labor migration which has reshaped the gender dynamics and health access landscape of urban China. Future chlamydia control efforts will require a population-based approach focused on reengaging sexually active adults of diverse economic and migratory backgrounds. Funding This was an unfunded study using routinely collected public health data.
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Affiliation(s)
- M. Kumi Smith
- Division of Epidemiology & Community Health, University of Minnesota Twin Cities, 1300 South 2 Street, Ste 300, Minneapolis, MN, USA
| | - Kelly M. Searle
- Division of Epidemiology & Community Health, University of Minnesota Twin Cities, 1300 South 2 Street, Ste 300, Minneapolis, MN, USA
| | - Wenyue Yang
- College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou, China
| | - Erica Rapheal
- Division of Epidemiology & Community Health, University of Minnesota Twin Cities, 1300 South 2 Street, Ste 300, Minneapolis, MN, USA
| | - Cheng Wang
- Dermatology Hospital of the Southern Medical University, No. 2 Lujing Road, Guangzhou, China
| | - Peizhen Zhao
- Dermatology Hospital of the Southern Medical University, No. 2 Lujing Road, Guangzhou, China
| | - Ligang Yang
- Dermatology Hospital of the Southern Medical University, No. 2 Lujing Road, Guangzhou, China
| | - Shujie Huang
- Dermatology Hospital of the Southern Medical University, No. 2 Lujing Road, Guangzhou, China
| | - Bin Yang
- Dermatology Hospital of the Southern Medical University, No. 2 Lujing Road, Guangzhou, China
- Corresponding author.
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6
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Tao Y, Chen MY, Tucker JD, Ong JJ, Tang W, Wong NS, Chu M, Zhuang X, Fairley CK, Zhang L. A Nationwide Spatiotemporal Analysis of Syphilis Over 21 Years and Implications for Prevention and Control in China. Clin Infect Dis 2021; 70:136-139. [PMID: 31237616 DOI: 10.1093/cid/ciz331] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 04/22/2019] [Indexed: 11/13/2022] Open
Abstract
Syphilis control programs have been scaled up due to the substantial burden in China. We analyzed syphilis incidence according to demographic, spatiotemporal, and economic factors. The increasing latent syphilis diagnoses and declining congenital syphilis suggest the effectiveness of scale-up screening. However, primary and secondary cases persist, especially in inland provinces.
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Affiliation(s)
- Yusha Tao
- Department of Epidemiology and Biostatistics, School of Public Health, Nantong University, Jiangsu, People's Republic of China, Melbourne, Australia.,School of Public Health and Preventive Medicine, Faculty of Medicine, Monash University, Melbourne, Australia
| | - Marcus Y Chen
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia.,Central Clinical School, Faculty of Medicine, Monash University, Melbourne, Australia
| | - Joseph D Tucker
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, North Carolina.,University of North Carolina Project-China.,SESH (Social Entrepreneurship to Spur Health) Global, Guangzhou, Guangdong, People's Republic of China, London, United Kingdom.,Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jason J Ong
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia.,Central Clinical School, Faculty of Medicine, Monash University, Melbourne, Australia.,Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Weiming Tang
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, North Carolina.,University of North Carolina Project-China.,SESH (Social Entrepreneurship to Spur Health) Global, Guangzhou, Guangdong, People's Republic of China, London, United Kingdom.,Dermatology Hospital, Southern Medical University, Guangzhou, Guangdong.,Guangdong Center for Skin Diseases and STI Control, Guangzhou, Guangdong
| | - Ngai Sze Wong
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, North Carolina.,University of North Carolina Project-China.,Stanley Ho Centre for Emerging Infectious Diseases, Chinese University of Hong Kong, Hong Kong
| | - Minjie Chu
- Department of Epidemiology and Biostatistics, School of Public Health, Nantong University, Jiangsu, People's Republic of China, Melbourne, Australia
| | - Xun Zhuang
- Department of Epidemiology and Biostatistics, School of Public Health, Nantong University, Jiangsu, People's Republic of China, Melbourne, Australia
| | - Christopher K Fairley
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia.,Central Clinical School, Faculty of Medicine, Monash University, Melbourne, Australia
| | - Lei Zhang
- School of Public Health and Preventive Medicine, Faculty of Medicine, Monash University, Melbourne, Australia.,Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia.,Central Clinical School, Faculty of Medicine, Monash University, Melbourne, Australia.,Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China
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7
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Ye X, Liu J, Yi Z. Trends in the Epidemiology of Sexually Transmitted Disease, Acquired Immune Deficiency Syndrome (AIDS), Gonorrhea, and Syphilis, in the 31 Provinces of Mainland China. Med Sci Monit 2019; 25:5657-5665. [PMID: 31361737 PMCID: PMC6685330 DOI: 10.12659/msm.915732] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 03/21/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND This study aimed to investigate trends in the epidemiology of the leading sexually transmitted diseases (STDs), acquired immune deficiency syndrome (AIDS), gonorrhea, and syphilis, in the 31 provinces of mainland China. MATERIAL AND METHODS This retrospective study analyzed the incidence data of STDs from official reports in China between 2004 and 2016. The grey model first order one variable, or GM (1,1), time series forecasting model for epidemiological studies predicted the incidence of STDs based on the annual incidence reports from 31 Chinese mainland provinces. Hierarchical cluster analysis was used to group the prevalence of STDs within each province. RESULTS The prediction accuracy of the GM (1,1) model was high, based on data during the 13 years between 2004 and 2016. The model predicted that the incidence rates of AIDS and syphilis would continue to increase over the next two years. Cluster analysis showed that 31 provinces could be classified into four clusters according to similarities in the incidence of STDs. Group A (Sinkiang Province) had the highest reported prevalence of syphilis. Group B included provinces with a higher incidence of gonorrhea, mainly in the southeast coast of China. Group C consisted of southwest provinces with a higher incidence of AIDS. CONCLUSIONS The GM (1,1) model was predictive for the incidence of STDs in 31 provinces in China. The predicted incidence rates of AIDS and syphilis showed an upward trend. Regional distribution of the major STDs highlights the need for targeted prevention and control programs.
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Affiliation(s)
- Xuechen Ye
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, P.R. China
| | - Jie Liu
- Department of Health Statistics, School of Public Health, China Medical University, Shenyang, Liaoning, P.R. China
| | - Zhe Yi
- Department of Prothodontics, School of Stomatology, China Medical University, Shenyang, Liaoning, P.R. China
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Wong NS, Chen L, Tucker JD, Zhao P, Goh BT, Poon CM, Yang L, Yang B, Zheng H, Huang S. Distribution of reported syphilis cases in South China: spatiotemporal analysis. Sci Rep 2018; 8:9090. [PMID: 29904141 PMCID: PMC6002518 DOI: 10.1038/s41598-018-27173-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 05/25/2018] [Indexed: 11/09/2022] Open
Abstract
There was a varied spatial distribution of reported syphilis cases across cities in South China. This study aims to identify and describe spatiotemporal clusters of primary and secondary syphilis (P/S) cases in this region. Reported syphilis cases in Guangdong Province, China, from January 2014 to June 2015 were collected from the national centralized reporting system. Spatiotemporal clusters of P/S were identified and cross-validated by calculating local Moran's I, performing hotspot analysis (Getis-Ord Gi*), and constructing a discrete Poisson model in SaTScan. Reported cases within and outside the clusters were compared by bivariable and multivariable logistic regression. Out of 17,691 reported P/S cases, 11% were in the identified spatiotemporal clusters. The monthly P/S notification rate (per 100,000 persons) ranged between 0.6 and 1. The identified clusters were located in 14, out of 126, counties in eight, out of 21, cities. Cases of older age, living in rural area and taking self-initiated syphilis test were more likely to be in the clusters. Some areas bore a greater burden of P/S in Guangdong Province. Routine spatiotemporal analysis of P/S cases may be useful for enhancing syphilis control programs by strategic location-based service planning.
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Affiliation(s)
- Ngai Sze Wong
- Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,University of North Carolina Project-China, Guangzhou, Guangdong, China.,Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China
| | - Lei Chen
- Dermatology Hospital, Southern Medical University, Guangzhou, Guangdong, China.,Guangdong Provincial Dermatology Hospital, Guangzhou, Guangdong, China
| | - Joseph D Tucker
- Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,University of North Carolina Project-China, Guangzhou, Guangdong, China.,SESH Global, Guangzhou, Guangdong, China
| | - Peizhen Zhao
- Dermatology Hospital, Southern Medical University, Guangzhou, Guangdong, China.,Guangdong Provincial Dermatology Hospital, Guangzhou, Guangdong, China
| | - Beng Tin Goh
- Guangdong Provincial Dermatology Hospital, Guangzhou, Guangdong, China.,Royal London Hospital, London, United Kingdom
| | - Chin Man Poon
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China.,The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Ligang Yang
- Dermatology Hospital, Southern Medical University, Guangzhou, Guangdong, China.,Guangdong Provincial Dermatology Hospital, Guangzhou, Guangdong, China
| | - Bin Yang
- Dermatology Hospital, Southern Medical University, Guangzhou, Guangdong, China.,Guangdong Provincial Dermatology Hospital, Guangzhou, Guangdong, China
| | - Heping Zheng
- Dermatology Hospital, Southern Medical University, Guangzhou, Guangdong, China. .,Guangdong Provincial Dermatology Hospital, Guangzhou, Guangdong, China.
| | - Shujie Huang
- Dermatology Hospital, Southern Medical University, Guangzhou, Guangdong, China. .,Guangdong Provincial Dermatology Hospital, Guangzhou, Guangdong, China.
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Barbosa CC, Bonfim CVD, de Brito CMG, Ferreira AT, Gregório VRDN, de Oliveira ALS, Portugal JL, de Medeiros ZM. Spatial analysis of reported new cases and local risk of leprosy in hyper-endemic situation in Northeastern Brazil. Trop Med Int Health 2018; 23:748-757. [DOI: 10.1111/tmi.13067] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Celivane Cavalcanti Barbosa
- Department of Collective Health; Aggeu Magalhães Institute; Oswaldo Cruz Foundation; Recife Brazil
- Department of Epidemiological Surveillance; First Health District of the State Health Department of Pernambuco; Recife Brazil
| | | | - Cintia Michele Gondim de Brito
- Department of Epidemiological Surveillance; First Health District of the State Health Department of Pernambuco; Recife Brazil
- Postgraduate Health Sciences; University of Pernambuco; Recife Brazil
| | - Andrea Torres Ferreira
- Department of Epidemiological Surveillance; First Health District of the State Health Department of Pernambuco; Recife Brazil
| | | | - André Luiz Sá de Oliveira
- Nucleus of Statistics and Geoprocessing; Aggeu Magalhães Institute; Oswaldo Cruz Foundation; Recife Brazil
| | - José Luiz Portugal
- Department of Cartographic Engineering; Federal University of Pernambuco; Recife Brazil
| | - Zulma Maria de Medeiros
- Postgraduate Health Sciences; University of Pernambuco; Recife Brazil
- Department of Parasitology; Aggeu Magalhães Institute; Oswaldo Cruz Foundation; Recife Brazil
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10
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Tao XH, Jiang T, Shao D, Xue W, Ye FS, Wang M, He MH. High prevalence of syphilis among street-based female sex workers in Nanchang, China. Indian Dermatol Online J 2014; 5:449-55. [PMID: 25396127 PMCID: PMC4228639 DOI: 10.4103/2229-5178.142491] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Female sex workers (FSWs) play a critical role in the heterosexual transmission of human immunodeficiency virus (HIV)/sexually transmitted infections (STIs) in China. Several studies reported that street-based FSWs have higher risk behaviors than establishment-based FSWs. Therefore, street-based FSWs should be specifically targeted for HIV and STIs intervention programs. Objectives: This study aims to investigate the prevalence rates and risk factors of HIV and syphilis among FSWs in Nanchang, China. Materials and Methods: Using convenience sampling methods, 361 street-based FSWs were recruited from August 2011 to February 2012. All participants completed an anonymous questionnaire on socioeconomic and sex behavioral information and were tested for HIV and syphilis. Risk for HIV and syphilis infection was assessed using univariate and multivariate logistic regression analyses. Results: No HIV infections were found. The prevalence rate of syphilis was 43.5%. Nearly 46.1% of street-based FSWs reported having education for no more than 6 years. Having reproductive tract infections at current visit, duration of sex work more than 5 years, indulgence in unprotected sex trade in the last time, unprotected sex trade in the last month, and unprotected sex with boyfriend or spouse in the last month were reported by 35.2%, 43.5%, 33.8%, 60.4%, and 93.1% street-based FSWs, respectively. In multivariate logistic regression analysis, having reproductive tract infections at current visit [odds ratio (OR), 12.10; 95% confidence interval (CI), 6.01-24.37], duration of sex work more than five years (OR, 4.26; 95% CI, 2.40-7.54), and unprotected sex trade in the last month (OR, 1.85; 95% CI, 1.06-3.22) were independently associated with syphilis infection. Conclusion: The prevalence rate of syphilis among street-based FSWs is very high. Most street-based FSWs in our survey had low education, long experience of commercial sex, and high rate of inconsistent condom use. Comprehensive interventions targeting this high-risk group, especially scaling up screening and ensuring consistent use of condoms during sex are needed.
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Affiliation(s)
- Xiao Hua Tao
- Department of Dermatology and STD, Dermatology Hospital of Jiangxi Province, The Affiliated Hospital of Nanchang University, Nanchang, 330000, Jiangxi Province, China
| | - Tao Jiang
- Department of Gynaecology, The First People's Hospital of Jiujiang, Jiujiang, 332000, Jiangxi Province, China
| | - Dan Shao
- Department of Dermatology and STD, Dermatology Hospital of Jiangxi Province, The Affiliated Hospital of Nanchang University, Nanchang, 330000, Jiangxi Province, China
| | - Wei Xue
- Department of Dermatology and STD, Dermatology Hospital of Jiangxi Province, The Affiliated Hospital of Nanchang University, Nanchang, 330000, Jiangxi Province, China
| | - Fa Shun Ye
- Department of Dermatology and STD, Dermatology Hospital of Jiangxi Province, The Affiliated Hospital of Nanchang University, Nanchang, 330000, Jiangxi Province, China
| | - Ming Wang
- Department of Dermatology and STD, Dermatology Hospital of Jiangxi Province, The Affiliated Hospital of Nanchang University, Nanchang, 330000, Jiangxi Province, China
| | - Mei Hua He
- Department of Dermatology and STD, Dermatology Hospital of Jiangxi Province, The Affiliated Hospital of Nanchang University, Nanchang, 330000, Jiangxi Province, China
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Abstract
OBJECTIVES China has experienced a sharply increasing rate of human brucellosis in recent years. Effective spatial monitoring of human brucellosis incidence is very important for successful implementation of control and prevention programmes. The purpose of this paper is to apply exploratory spatial data analysis (ESDA) methods and the empirical Bayes (EB) smoothing technique to monitor county-level incidence rates for human brucellosis in mainland China from 2004 to 2010 by examining spatial patterns. METHODS ESDA methods were used to characterise spatial patterns of EB smoothed incidence rates for human brucellosis based on county-level data obtained from the China Information System for Disease Control and Prevention (CISDCP) in mainland China from 2004 to 2010. RESULTS EB smoothed incidence rates for human brucellosis were spatially dependent during 2004-2010. The local Moran test identified significantly high-risk clusters of human brucellosis (all p values <0.01), which persisted during the 7-year study period. High-risk counties were centred in the Inner Mongolia Autonomous Region and other Northern provinces (ie, Hebei, Shanxi, Jilin and Heilongjiang provinces) around the border with the Inner Mongolia Autonomous Region where animal husbandry was highly developed. The number of high-risk counties increased from 25 in 2004 to 54 in 2010. CONCLUSIONS ESDA methods and the EB smoothing technique can assist public health officials in identifying high-risk areas. Allocating more resources to high-risk areas is an effective way to reduce human brucellosis incidence.
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Affiliation(s)
- Junhui Zhang
- West China School of Public Health, Sichuan University, Chengdu, People's Republic of China
- School of Public Health, Luzhou Medical College, Luzhou, People's Republic of China
| | - Fei Yin
- West China School of Public Health, Sichuan University, Chengdu, People's Republic of China
| | - Tao Zhang
- West China School of Public Health, Sichuan University, Chengdu, People's Republic of China
| | - Chao Yang
- School of Public Health, Luzhou Medical College, Luzhou, People's Republic of China
| | - Xingyu Zhang
- West China School of Public Health, Sichuan University, Chengdu, People's Republic of China
| | - Zijian Feng
- Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Xiaosong Li
- West China School of Public Health, Sichuan University, Chengdu, People's Republic of China
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Evaluation of the recombinant protein TpF1 of Treponema pallidum for serodiagnosis of syphilis. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2013; 20:1563-8. [PMID: 23945159 DOI: 10.1128/cvi.00122-13] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Syphilis is a chronic infection caused by Treponema pallidum subsp. pallidum, and diagnosis with sensitive and specific methods is a challenging process that is important for its prevention and treatment. In the present study, we established a recombinant protein TpF1-based indirect immunoglobulin G (IgG) enzyme-linked immunosorbent assay (ELISA) and a Western blot assay for human and rabbit sera. The 20-kDa recombinant protein TpF1 was detected by Western blotting performed with sera from rabbits immunized with recombinant TpF1 and infected with the T. pallidum Nichols strain and T. pallidum clinical isolates but was not detected by Western blotting with sera from uninfected rabbits. The sensitivity of the recombinant protein was determined by screening sera from individuals with primary, secondary, latent, and congenital syphilis (n = 82). The specificity of the recombinant protein was determined by screening sera from uninfected controls (n = 30) and individuals with potentially cross-reactive infections, including Lyme disease (n = 30) and leptospirosis (n = 5). The sensitivities of TpF1-based ELISAs were 93.3%, 100%, 100%, and 100% for primary, secondary, latent, and congenital syphilis, respectively, and the specificities were all 100% for sera from uninfected controls and individuals with potentially cross-reactive infections. In Western blot assays, the sensitivities and specificities of TpF1 for human sera were all 100%. The reactivities of TpF1 with syphilitic sera were proportional to the titers of the T. pallidum particle agglutination (TPPA) assay. These data indicate that the recombinant protein TpF1 is a highly immunogenic protein in human and rabbit infections and a promising marker for the screening of syphilis.
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